Surgery for nonlocalizing hyperparathyroidism in high volume center. Head Neck 2024 Jul;46(7):1788-1794
Date
02/16/2024Pubmed ID
38362817DOI
10.1002/hed.27686Scopus ID
2-s2.0-85185692925 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: Patients with nonlocalizing hyperparathyroidism pose a significant challenge to surgeons when undergoing neck exploration for parathyroidectomy.
METHODS: We evaluated 536 patients that had parathyroidectomy for primary hyperparathyroidism (PHPT) from 2005 to 2018 at a single tertiary academic center, and 155 (29%) had standard nonlocalizing preoperative imaging (negative ultrasound and sestamibi scans).
RESULTS: There were a total of 102 (66%) non-ectopic single adenomas in the nonlocalizing group and 325 (85%) single adenomas in the localizing group. There was no significant difference (p = 0.09) in adenoma quadrant between localizing and nonlocalizing single adenomas, but the most common location in both groups was right inferior. Patients with nonlocalizing scans were more likely to have double adenomas (21% vs. 9%, p < 0.001), ectopic glands (10% vs. 5%, p = 0.052), and multi-gland disease (13% vs. 8%, p = 0.002).
CONCLUSION: Nonlocalizing PHPT patients experienced similar cure and complication rates as localizing PHPT, but required more bilateral explorations and increased operative time.
Author List
Miller AB, Frank E, Simental AA Jr, Feng MAuthor
Max Feng MD Instructor in the Otolaryngology and Communication Sciences department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenomaAdult
Aged
Female
Hospitals, High-Volume
Humans
Hyperparathyroidism, Primary
Male
Middle Aged
Parathyroid Neoplasms
Parathyroidectomy
Retrospective Studies
Technetium Tc 99m Sestamibi
Treatment Outcome
